Rheumatology

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Prevalence of exercise pulmonary arterial hypertension in scleroderma
Journal of Rheumatology, 07/17/08

Callejas-rubio JL et al. - The prevalence of exercise-induced pulmonary arterial hypertension (PAH) in pts with scleroderma is high. Patients with lower DLCO and higher levels of brain natriuretic peptide (BNP) are at higher risk of developing higher sPAP.

• Prevalence of exercise-induced PAH in SSc pts was determined
• Relation between exercise-induced PAH and clinical characteristics and biochemical markers was examined
• Pts with SSc and normal resting systolic pulmonary arterial pressure (sPAP) were studied
• 8 pts were asked to perform cycloergometer exercise until exhaustion, and exercise sPAP was measured
• All pts had their pulmonary function tested and underwent echocardiography at rest
• Brain natriuretic peptide (BNP) was also determined

• 41 pts with SSc were studied
• Mean sPAP at rest was 29.7 mm Hg, rising to a mean of 41.4 mm Hg on exercise
• 26.8% of pts had sPAP post-exercise >50 mm Hg and 19.5% >55 mm Hg
• A significant correlation was found between exercise sPAP and DLCO and between sPAP and BNP levels
• Pre-existing severe Raynaud's phenomenon was more prevalent, DLCO levels lower, and BNP levels higher in pts with exercise sPAP >55 mm Hg

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